Building or Restoring Your Authentic Self

What is Psychoanalysis?dreamstime_xxl_31408487

Why psychoanalysis over another modality? Today we answer these questions more broadly than Sigmund Freud would have over 100 years ago. For Freud, psychoanalysis was aimed at liberating the self from unconscious sexual conflict which, he argued, debilitated a person by embroiling him or her in an ongoing but unconscious argument that resulted in a stalemate, of sorts, but which also caused anxiety and depression and robbed a person of a sense of well-being.

Today, psychoanalysis looks to build or restore a sense of well-being in patients, but takes a broader view of the causes for distress.

Psychoanalysis is unique among the mental health sciences. Psychoanalysis alone holds that the unconscious aspects of the self—those aspects that are beyond immediate awareness—are instrumental in shaping human behavior, including thought, states of mind and perspective, and are instrumental in framing one’s capacity for relatedness.

Psychoanalysis privileges the unconscious. One of its principle aims is the illumination and understanding of unconscious process, and the resolution of areas of conflict, trauma, or deficit within the unconscious that have influenced and, indeed, undermined functioning.
Psychoanalysis is not advocacy or career counseling. Psychoanalysis is not cognitive behavioral modification. It is not surrogacy, hypnosis, spiritual advice, rehabilitation, or brief, solution-focused therapy. Psychoanalysis is not psychological testing for developmental deficits. It is not sensory integration training or anger management. Psychoanalysis is not the formulaic application of theory or technique.

Rather, psychoanalysis is the dignified and emphatic inquiry into mind using the principles of transference and resistance that were first articulated by Sigmund Freud in the nineteenth century and which have evolved, since then, into a robust professional discourse reflecting the current diversity, breadth, and relevance of the field.

The training to practice psychoanalysis is rigorous. In addition to stringent clinical training and academic training on a par with doctoral-level work, psychoanalysts undergo their own analysis which is integral to their professional preparation, putting them in the unique position among mental healthcare providers to be competent in the management of unconscious aspects of the treatment, which ultimately is the lynchpin for healthy resolution.

In spite of mixed publicity in the mainstream press, and in spite of ongoing attempts on the part of healthcare administrators, policy makers, and the health insurance industry to call psychoanalysis into doubt, “the scientific evidence tells a different story: considerable research supports the efficacy and effectiveness of psychodynamic psychotherapy.” Shedler, “The Efficacy of Psychodynamic Psychotherapy” American Psychologist 2009.

The contribution that psychoanalysis makes and its current relevance to the mental healthcare consumer is clear: psychoanalysis offers the only treatment in which permanent structural change can be brought about in individual functioning across a broad spectrum.

This has a few important consequences. Given its highdreamstime_xxl_33126137 success rate and low recidivism rate, psychoanalysis has a proven record in providing successful mental health treatment. (In 2008, the Journal of the American Medical Association reported that in a large-scale meta analysis of 23 previously published studies on the efficacy of psychodynamic therapy—a form of psychoanalysis—it was very effective, especially in complex cases. See JAMA October 2008. This is compared to the more minimal protective effects of cognitive behavioral treatment, for example, whose efficacy is shown to fade in a four-year follow-up. See American Journal of Psychiatry, 155:1443-1444 1998; see also Shedler, “The Efficacy of Psychodynamic Psychotherapy” American Psychologist 2009.